Four years ago, the hot new idea for reining in health costs was the health savings account, a savings vehicle tied to a high-deductible insurance policy and designed to make patients more responsible for - and more aware of - the expenses involved.

Shock and awe - we are living it! We stand, mouth agape, staring at the pump - at $4 gallons and fast-emptying pocketbooks. Even worse, with crude oil already costing more than $120 a barrel, many predict this wave has yet to crest.